Gallstones may cause sudden, intense pain in a person’s abdomen that may spread to the back or shoulders. In rare cases, gallstones may cause pain in the pelvis.

Gallstones, which healthcare professionals may refer to as cholelithiasis, are pebble-like deposits that form in the gallbladder. The deposits typically comprise hardened bilirubin or cholesterol.

Gallstones are very common, affecting 10–15% of the United States population, which equates to nearly 25 million people. In many cases, gallstones do not cause problems. However, around a quarter of the approximately 1 million people who receive a gallstone diagnosis each year require treatment.

Gallstones often cause pain when they get stuck while passing through the bile duct. Blockages in the bile duct may also cause complications if a person does not receive treatment.

This article explores where a person may feel pain due to gallstones, including whether they may cause pain in the pelvis or hips. It also discusses other symptoms relating to gallstones, treatment for gallstones, and when to speak with a doctor.

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When gallstones block the bile duct, bile may build up in the gallbladder and cause an attack in the area, which doctors also call biliary colic.

During a gallbladder attack, a person may experience sudden, intense pain in the upper right abdomen that typically lasts between 1 and 5 hours. This pain may radiate to the right shoulder blade or middle back area. It often occurs during the night, usually after eating heavy meals or spicy or greasy foods.

Pain following cholecystectomy

Laparoscopic cholecystectomy is a surgical procedure where a surgeon removes the gallbladder. According to research, laparoscopic cholecystectomy is the gold standard treatment for gallstones that cause symptoms.

Gallstone perforation is a common complication in laparoscopic cholecystectomy that may result in spilled or lost gallstones. Spilled gallstones, or gallstones spilling into the abdominal cavity, occur in 6–40% of procedures, while 13–32% of these procedures result in lost stones.

The following are common sites where healthcare professionals find lost stones:

  • right subhepatic region, or to the lower right of the liver
  • right perihepatic region, or the area surrounding the right part of the liver
  • right retroperitoneal region, or the area behind the right part of the peritoneum, a membrane that lines the abdominal cavity
  • right flank, or the area between the right ribs and hip
  • right pelvis

According to 2019 research, lost stones that end up in the peritoneal cavity may cause complications many years after the operation, from 2 months up to 20 years.

Pain is among the most common symptoms of lost stones. Several case studies indicate that lost gallstones may cause pelvic pain.

One 2021 case study discussed a person who experienced pelvic pain after having multiple gallstones in the pelvic cavity following laparoscopic cholecystectomy. After doctors performed a laparoscopy to remove the lost gallstones, the individual’s pain resolved.

In another 2020 case study, a person experienced painful swelling in the suprapubic region — the area above the pubic bone — due to lost gallstones 10 years after laparoscopic cholecystectomy.

Aside from severe or persistent pain, a person with gallstones may experience the following:

People who are not experiencing symptoms relating to gallstones may not require treatment.

Healthcare professionals typically treat gallstones with surgery. Doctors may also use nonsurgical treatments for cholesterol stones, while pigment stones, which consist of bilirubin, typically require surgery.

Surgeons may perform an open or laparoscopic cholecystectomy, which is a surgical procedure to remove the gallbladder.

Typically, healthcare professionals recommend laparoscopic cholecystectomy on an outpatient basis, meaning a person may be able to return home on the same day as the surgery. Individuals may be able to return to their usual physical activities in about a week.

Doctors may recommend open cholecystectomy if a person has a severely inflamed or scarred gallbladder on an infection in the organ due to other operations. A person may need to stay in the hospital for up to a week following the procedure and return to their usual physical activities after roughly a month.

Nonsurgical treatments for gallstones include:

A person should speak with a doctor as soon as possible if they experience the following symptoms during or after a gallbladder attack:

These symptoms may indicate severe infection or inflammation of the gallbladder, pancreas, or liver. Additionally, without treatment, bile duct blockage can be fatal.

Gallstones can cause severe pain when they obstruct the bile ducts. People typically feel this pain in the upper right abdomen. Rarely, gallstones may cause pain in the pelvis. Case studies indicate that pelvis pain may occur due to lost gallstones, a complication of laparoscopic cholecystectomy that often occurs many years after surgery.

Treatment for gallstones includes nonsurgical options, such as oral dissolution therapy, or surgery. A person experiencing symptoms of gallstones should speak with a healthcare professional as soon as possible to help avoid complications such as serious infection or inflammation.